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Original Articles: Adult Cardiac

Biomarker Profile in Off-Pump and On-Pump Coronary Artery Bypass Grafting Surgery in Low-Risk Patients

^a Institute of Immunology, Rikshospitalet HF, University of Oslo, Oslo, Norway
^b Department of Thoracic and Cardiovascular Surgery, Rikshospitalet HF, University of Oslo, Oslo, Norway
^c Institute of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, and Department of Immunology and Transfusion Medicine, St. Olav University Hospital, Trondheim, Norway
^d Interventional Center, Rikshospitalet HF, Oslo, Norway

Accepted for publication March 5, 2008.

^_* Address correspondence to Dr Castellheim, Institute of Immunology, Rikshospitalet, Oslo, NO-0027, Norway (Email: albert.castellheim{at}medisin.uio.no).

Background: The purpose of this study was to investigate the cytokine and chemokine profile in low-risk patients undergoing off-pump and on-pump coronary artery bypass grafting (CABG) surgery by use of a broad panel of cytokines and chemokines.

Methods: Eight consecutive blood samples were obtained from patients enrolled into a prospective, randomized study comparing off-pump and on-pump CABG in a low-risk population. Eleven patients from each group were randomly selected for analysis of 25 different cytokines and chemokines using multiplex technology. Data were compared using two-way repeated measures analysis of variance.

Results: Of the 25 biomarkers analyzed, 11 were not detected while 14 increased significantly in both groups. Only three mediators, eotaxin, macrophage inflammatory protein (MIP)-1β, and interleukin (IL)-12 were significantly different between the two groups, increasing more in the on-pump than in the off-pump group (p < 0.001, p < 0.01, and p < 0.05, respectively). There was a marked, comparable increase in the concentrations of the cytokines IL-6, IL-10, IL-15, and IL-1Ra as well as the chemokines inducible protein (IP)-10, monokine induced by interferon gamma (MIG), monocyte chemoattractant protein 1 (MCP-1), and regulated on activation, normal T cell expressed and secreted (RANTES) in both groups (p < 0.001 for all). There was only a modest, but still statistically significant, increase in IL-8, tumor necrosis factors , and IL-2R, without any intergroup differences. When corrected for hemodilution the production of the antiinflammatory biomarkers IL-1Ra and IL-10 were significantly higher in the on-pump group (p < 0.001 for both).

Conclusions: The cytokine and chemokine production profile of the inflammatory response associated with CABG is largely similar using the off-pump and on-pump techniques in low-risk patients, but slightly higher concentrations of eotaxin, MIP-1β, and IL-12 were found in the on-pump group.

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